If I remember correctly (from an incident that was in the news a few
years back) it is not always lawful to have a sliding scale if you are
taking Medicaid payments.  It falls into the category of Medicaid fraud
if you charge Medicaid more than you charge another payer (even someone
who pays out of pocket)  A physician who was just trying to do good,
ended up in a lot of trouble over this.

Not a problem for most LC's, as I doubt most get Medicaid reimbursement.
 Still, something to think about in the very messy world of payment for
services.

Pam Rardon RN, IBCLC
Anchorage, Alaska

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